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Anales de la Facultad de Ciencias Médicas (Asunción)

Print version ISSN 1816-8949

Abstract

PIRES, Francisco Adrián; MENA CANATA, Carlos; ORTIZ, José Luís  and  TORNACO, Raúl. Therapeutic results of recurrent respiratory papillomatosis in otorhinolaryngology Hospital de Clinicas period 2005 to 2020. An. Fac. Cienc. Méd. (Asunción) [online]. 2022, vol.55, n.2, pp.68-81. ISSN 1816-8949.  https://doi.org/10.18004/anales/2022.055.02.68.

Introduction:

Recurrent respiratory papillomatosis is the growth of papillomatous lesions in the aerodigestive tract caused by human papillomavirus, appears more between the ages of 3 and 6 years (juvenile) and between the third and fifth decades (adult). Symptoms are usually dysphonia and respiratory distress. The therapy consists of resection of lesions and adjuvant therapy (bevacizumab and interferon). Its course is variable, it tends to recur and malignancy occurs in 3-7%, more in adults.

Objectives:

To describe therapeutic results of recurrent respiratory papillomatosis in our service.

Materials and methods:

Observational, descriptive, cross-sectional, cross-sectional, retrospective, retrospective, non-probabilistic sampling of consecutive cases, of patients with recurrent respiratory papillomatosis operated in the Otorhinolaryngology Department of the Hospital de Clínicas in the period 2005-2020.

Results:

We studied 40 patients, 65% male and 35% female; 35% adults and 65% juveniles. Mean age was 16.05±18.042 years. In juvenile cases the mean age was 4.69±2.908 years, in adults 37.14±14.94 years. Voice alterations were observed in 100% and respiratory mechanics in 72.5%. There were 119 procedures, 11 laryngeal microsurgery alone, 29 associated with adjuvant, of these 22.5% received bevacizumab and 50% interferon. There was no significant difference in the mean time without lesions between young people and adults (p>0.05), but there was a favorable trend with adjuvant therapy, especially with bevacizumab. Dysplasia was found in 10% and malignization in 2.5%. The involvement was: glottis 100% (right vocal cord 92.5%, left 82.5%, both 77.5%, anterior commissure 62.5%), supraglottis 20% and subglottis 10%. The average number of affected areas was 3.34±1.274, there was a significant difference (p<0.05) between adult (2.071±0.379) and juvenile (3.846±1.015) cases, with greater involvement in the latter.

Conclusion:

Most of the cases were juvenile male cases. The most affected areas were the glottis, especially vocal cords. A greater number of affected regions were seen in young people. All presented dysphonia or aphonia, followed by respiratory distress. Therapeutics were surgical resection alone or associated with adjuvant therapy (bevacizumab or interferon). The time to recurrence was longer when adjuvant therapy was used, with a favorable trend towards bevacizumab. Malignization occurred in one case.

Keywords : Papilloma; Dysphonia; Papillomavirus Infections; Papillomaviridae; Respiratory Distress..

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